Tonic-clonic seizures: symptoms, causes and treatment

Definition of a tonic-clonic seizure

What are tonic-clonic seizures?

A tonic-clonic seizure or grand mal seizure is a type of seizure that involves the entire body, because it involves both sides of the brain.

This condition occurs when an electrical signal travels to the brain inappropriately to the muscles, nerves or glands of your body. This improper distribution of signals can cause your muscles to contract so badly that you lose consciousness.

This type of seizure has two distinct stages. In the tonic stage, your muscles will tighten. This condition causes you to fall or lose consciousness while doing activities. While at the clonic stage, the muscles will contract rapidly and this is called a spasm.

Usually these seizures last for 1-3 minutes. If it lasts more than this time, it is a sign of emergency and requires immediate medical attention.

How common are these seizures?

Tonic-clonic seizures (grand mal seizures) are a common type of seizure. Usually, these seizures are associated with epilepsy (epilepsy). However, in some cases it can also be caused by other causes, such as a high fever or a head injury.

Usually, these seizures occur in children through adolescence. However, it rarely affects children under 2 years of age.

Signs & symptoms of tonic-clonic seizures

What are the symptoms of tonic-clonic seizures?

Tonic clonic seizures (grand mal seizures) are a condition characterized by symptoms such as hallucinations, dizziness, and problems with the senses (vision, taste, and smell).

Afterward, the muscles will contract with other symptoms, such as:

• Biting on the cheek or tongue.
• Grit your teeth.
• Uncontrolled urination.
• Difficulty breathing
• Pale skin.

Once the condition is under control, the patient will be conscious or have the following symptoms:

• Dazed.
• Drowsiness and sleep longer than usual.
• Can't remember what happened during a seizure.
• Headache.
• One side of the body weakens for several minutes or hours.

There may be other symptoms not listed above. If you have any concerns or questions regarding this condition, consult your doctor.

When to see a doctor?

If you experience the signs and symptoms listed above, see a doctor immediately. Especially if the seizure lasts more than 3 minutes and you don't know the underlying cause.

Reporting from the Mayo Clinic page, other conditions that require you to see a doctor are:

• After the first seizure was over, there were more seizures.
• Breathing or awareness does not return after the seizure has stopped.
• After a seizure, the body feels weak or is accompanied by a high fever.
• During a seizure, injury occurs to the body.
• You are pregnant or have diabetes.

Causes of tonic-clonic seizures

The cause of a tonic-clonic seizure (grand mal seizure) is brain waves that work abnormally. In addition, seizures may result from several other health problems, such as:

• Brain injury or brain infection.
• Lack of oxygen.
• Stroke
• Brain vascular malformations.
• Brain tumor.
• Low levels of sodium, calcium and magnesium.

Risk factors for tonic-clonic seizures

The following are various factors that can increase the risk of tonic-clonic seizures (grand mal seizures):

• Family history of similar conditions.
• Brain damage such as injury, stroke, infection, and other causes.
• Have a sleep disorder.
• Health problems that affect electrolyte balance in the brain.
• Alcohol or drug abuse.

Diagnosis & treatment of tonic-clonic seizures

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

The doctor will look at your medical history and family and ask about the various symptoms you are experiencing. In addition, to make a diagnosis of tonic clonic seizures (grand mal seizures) the doctor will ask you to take a series of medical tests.

Examinations that can be done to make a diagnosis

Several types of examinations that can be done, such as:

• Neurological examination

Your doctor tests your behavior, motor skills, and mental function to determine if you have problems with your brain and nervous system.

• Blood test

Your doctor may take a blood sample to check for signs of infection, genetic conditions, blood sugar levels or electrolyte imbalance.

• Lumbar puncture

If your doctor suspects an infection as the cause of the seizure, you may need to remove a cerebrospinal fluid sample for testing.

• Electroencephalogram (EEG)

In this EEG test, the doctor attaches electrodes to the scalp to check for electrical activity in the brain.

• Scan test

Imaging tests such as CT scan, MRI, PET scan with the aim of detecting lesions in the brain, the presence of tumors, and abnormalities in the brain.

• SPECT test (Single-photon emission computerized tomography)

This test is used to look at the blood flow activity in your brain that occurs during a seizure.

What are the treatment options for tonic-clonic seizures?

The following are various treatments for tonic-clonic seizures (grand mal seizures):

Taking medication

There are many types of drugs that doctors prescribe to treat these types of seizures, such as:

• Carbamazepine (Carbatrol, Tegretol, others).
• Phenytoin (Dilantin, Fenitek).
• Valporic acid (Depakene).
• Oxcarbazepine (Oxtellar, Trileptal).
• Lamotrigine (Lamictal).
• Gabapentin (Gralise, Neurontin).
• Topiramate (Topamax).
• Phenobarbital.

In most cases, doctors prescribe only one type of seizure medication. However, if it is not effective, the doctor will try a combination of drugs.

The use of these drugs can cause side effects, such as fatigue, dizziness, and weight gain. If you experience rashes, mood swings, and coordination problems, consult your doctor immediately.

Operation

If the spasm does not improve with medication, surgery will usually be performed. The goal is to remove areas of the brain that experience abnormal electrical signals.

Therapy

In addition to taking medication and surgery, patients with seizures may also be asked to undergo therapy, such as:

• Stimulation of the vagus nerve

A device implanted under the skin of your chest stimulates the vagus nerve in your neck, sending signals to your brain that block seizures. With vagus nerve stimulation, you may still need to take medication, but you may be able to lower the dose.

• Responsive neurostimulation

During responsive neurostimulation, a device that is implanted on the surface of your brain or inside brain tissue. The goal is to detect seizure activity and send electrical stimulation to the detected area to stop seizures.

• Deep brain stimulation

Doctors implant electrodes in specific areas of your brain to produce electrical impulses that regulate abnormal brain activity. The electrodes attach to a pacemaker that is placed under the skin of your chest, which controls the amount of stimulation it produces.

Home remedies for tonic-clonic seizures

In addition to undergoing medical treatment, patients with tonic-clonic seizures (grand mal seizures) also receive home care, including:

• Take medicines according to doctor's instructions. If you experience disturbing side effects, consult your doctor further. And always check your health regularly.
• Make sure you get enough sleep, as lack of sleep can trigger seizures by stimulating changes in electrical activity in the brain. If you have sleep disorders, consult your doctor further.
• Exercise regularly to maintain overall body health and help manage stress. Make sure you also drink enough and rest after exercising.
• Doctors may also recommend the keto diet for people who have seizures. However, in undergoing this diet, patients need to be supervised by a doctor or nutritionist.

Prevention of tonic-clonic seizures

The way to prevent tonic-clonic seizures is to know the triggers and avoid them. However, not all seizures are known to be the exact trigger. Some of the steps you can take are:

• Avoid traumatic brain injury by using motorcycle helmets, seat belts, and cars that you are equipped with airbags .
• Always practice good hygiene to avoid viral or parasitic infections that can cause seizures, such as epilepsy.
• Current pregnant women follow routine care and counseling to monitor the health of the mother's body and the fetus.
• Your little one should get immunized to prevent diseases that attack the central nervous system and cause the body to go into spasms.
• Reduce self-risk factors for stroke, by keeping blood pressure and cholesterol levels stable, exercising regularly, and quitting smoking.